Governance Issues in the Transition to Accountable Care: A Case Study of Silver Cross Hospital.

Recent developments in healthcare reform legislation and in the private-payer marketplace have increased impetus toward clinical integration. Industry changes require that healthcare delivery institutions confront fundamental scope and scale structural issues that may lead to increased vertical integration. To accomplish integration, firms must decide the organizational form of integration (alliance or merger/acquisition). One form of integration, accountable care organizations (ACOs), has featured prominently in recent legislation. Clinical integration and ACOs present significant shared-governance challenges that must be understood by hospital boards. The author outlines these governance issues using a case study of Silver Cross Hospital's governance structure for its ACO. [ABSTRACT FROM AUTHOR]